Two doctor visits a year linked to better blood pressure control

People who went to their doctor’s office at least twice a year were more likely to keep their blood pressure under control compared to those who went once a year or not at all, says a new study.

Having health insurance and following treatment for high cholesterol were also linked to better blood pressure control.

“Folks that go to the doctor at least twice a year are more likely to be aware of their blood pressure, more likely to be treated, more likely to be controlled when treated and have significantly better control rates,” Dr. Brent Egan, who led the study, told Reuters Health.

“People with uncontrolled high blood pressure have a greater risk for having a stroke, having a heart attack, having heart failure and even memory loss without having a stroke,” said Egan, of University of South Carolina School of Medicine in Greenville.

He added that most people may not be aware of the fact that memory loss with aging is greater in people who have high blood pressure that's uncontrolled.

“So there are number of reasons why it's a good thing to get the blood pressure control,” said Egan, who is also medical director of the non-profit Care Coordination Institute.

About one of every three Americans has high blood pressure, which is defined as having a reading above 140/90 mmHg. Only about half of adults with high blood pressure have it under control, the study team writes in the journal Circulation.

A national health promotion and disease prevention initiative called Healthy Living 2020 established goals to reduce the rate of high blood pressure in the U.S. from 30 percent of all adults to 27 percent, and to increase the rate of blood pressure control to greater than 60 percent of people with high blood pressure.

Egan and his colleagues designed the study to see how those goals are coming along. They looked at data on participants in the annual National Health and Nutrition Examination Survey who had their blood pressure checked during the period from 1999 to 2012.

The researchers found that people who were obese, didn’t have insurance and didn’t see their doctors were more likely to have untreated high blood pressure.

Egan and his team also examined what factors were associated with good blood pressure control.

“One of the things we were looking at in this analysis was some of the modifiable variables that might, if we paid more attention to them, might help move us towards the goal,” Egan said.

The study team discovered that people who saw their doctors at least two times a year were more than three times more likely to get their blood pressure under control as those who saw a doctor less often.

People with health insurance were about 70 percent more likely than those without it to have their blood pressure controlled.

In addition, people who had high blood pressure and were being treated for high cholesterol were almost twice as likely to have their blood pressure under control.

“Many people, in fact the majority of people with high blood pressure, also have a cholesterol problem,” Egan said. “What our data shows is that if they're also being treated for the cholesterol they're more likely to get their blood pressure under control.”

Egan said that when doctors control both high blood pressure and cholesterol, “we reduce heart disease and stroke by about 60 percent; if we treat only one we reduce it by about 30 percent, so it's a really good idea to get both treated.”

Egan also said he thinks the Healthy Americans 2020 target of 61.2 percent, or a little over three out of every five people, with high blood pressure being controlled is an excellent goal.

“Right now we're 10 percent below the goal and it looks like we've pretty much stabilized for the last six to seven years, and so it's clearly going to require some new efforts to get another round of progress,” Egan said

“It’s sort of what we’ve known for years, that about a third of Americans are hypertensive and hypertension correlates with obesity,” Dr. Ronald Wharton told Reuters Health.

“Patients who tend to go to the doctor more are going to be in tune with their health and be more likely to take their health seriously,” said Wharton, a cardiologist with Montefiore Medical Center in New York who wasn’t involved in the study.

Wharton said that obesity, cholesterol problems, hypertension and diabetes are not "independent parameters" – they’re all interrelated.

“When people take care of one problem, they’re really taking care of multiple problems at the same time,” Wharton said.

But, "the data says we’ve come a long way and we’ve got a long way to go," Wharton added.

“What we’re facing in healthcare with obesity and hypertension, diabetes and all the ramifications is going to put an expense on the healthcare system that’s going to make smoking-related illnesses look like a drop of sand on the beach,” Wharton said.

Egan said that cardiovascular disease is projected to increase healthcare costs tremendously over the next 15 years or so, roughly doubling the current cost.

“Treating hypertension certainly is one of the ways to reduce that health burden,” he said.